Low Stomach Acid - test??
I have been reading a little bit on here and other message boards about a test that can be done for low stomach acid. It's a pill you can swallow that will measure the pH of your stomach and transmit the result via a built-in radio transmitter... at least that's how I think it works. I have so far asked 2 GI doctors and 1 ENT about this test, and they have all just looked at me dumbfounded. They've never even heard of such a thing.
I suspect I might have low stomach acid, since my LPR isn't responding to PPI's, and I also have quite a few symptoms of low acid. I'd really like to find out for sure if this could be my problem.
Has anyone had this test done? Is it expensive? Is there a reason why none of the doctors I've seen have heard of it?
You don't swallow the capsule...it is implanted by your gastro doctor. It is called the Bravo.
I had that test done at the Tahoma, WA clinic of naturopathic Dr. Jonathan Wright nearly 20 years ago. I wasn't there for upper GI reasons, I was there for lower GI reasons, but he had me do that test anyway. It was a little pill-like device attached to a string, which I swallowed, and after some period of time at the end of the test it was pulled up via the string. I don't recall how bothersome the test was, but in any case, he prescribed me some HCL pills to take with all my meals. They made my stomach burn. In retrospect, I feel I was young and naiive and should never have taken any HCL pills. There are lots of naturopath doc's who like to say that gerd is due to low stomach acid, and that our food sits in our guts too long due to low stomach acid, and that we therefore reflux our little bit of stomach acid due to the food sitting there so long. There are no credible research reports out to corroborate this as far as I know. Personally, just my 2cents, I don't buy the low acid idea. I think it's grasping at thin air at best for a diagnosis, and snake oil selling at worst. I don't mean to discourage you from following up on any and all possible avenues to help yourself, but you might ask whatever doc you're interested in, what regimen they would put you on if you are found to have low acid, and just try the regimen empirically and see how it goes. Chances are, the regimen will consist of trying some HCL or digestive enzyme pills. Digestive enzymes do seem to be reported as helpful here and there by some folks. NY'er for example seems to like Absorbaid.
Aha! That test with the string sounds like what I was talking about, and I didn't realize it was an alternative medicine test. That would explain why my GI doctors looked at me as if I was crazy when I asked about it! If it isn't a proven test, then I wont bother with it.
I was reading about low stomach acid on some chronic fatigue syndrome/fibromyalgia message boards (because I have both of those illnesses), and people there seemed to think that there was a higher incidence of low stomach acid amongst CFS sufferers. I guess a lot of them are going to naturopath doctors and getting diagnosed with it or something. A lot of them say they took the HCL acid pills and they helped immensely though.
I had an endoscopy done a few weeks ago, but the doctor wasn't looking/testing for low acid when I had it done. I'm not sure if a specific test needs to be done, or if it's just obvious from the images?
I will ask about that Bravo test... though I'm not sure how useful it would be to me if I don't get heartburn. How do you test for an *absence* of acid? Hmm.
Thanks for clearing that up guys, I appreciate it!
Hi Cheryl Well , if you aren't 80 years old , most commonly people who get this type of thing are people who have had gastric surgery , people with h pylori and on high long term dosages of PPIS .
Usually there is some indication , a B12 problem , a poylp problem . or at least most definately gastritis for example , which is caused in part by an imbalace of pepsin vs acid vs bile in the stomach.
There are tests for low acid like the pentagastrin stimulation test and 24-hour gastric pH study where they test fluid from your stomach ...... that a GI can do if he suspected this by your endoscopy for example .
If he sees no indication , he isn't apt to test for it , and may give you that look again , but it never hurts to discuss it . I've seen chronic fatigue syndrome linked to low B 12 , have you had your B 12 levels checked ? You could ask for pepsin and gastrin blood tests as well . You could try the HCL pills as Mark suggested . If they help , it may not be because you have low acid , it could be from placebo effect which is very high in people with GERD / LPR symptoms or another mechanism. .
You don't need heartburn to test positive for a Bravo test . You may want to consider that option . Good luck to you
On my last endo and the one before that, they both had on the diagnosis of gastritis among others but I specifically remember gastritis........so are you saying that gastritis will cause you to have low acid?.......not sure I understand what your saying here.......thanks........
Hi Thelmalou Most people with GERD have gastritis ... and no it doesn't mean you have low acid . Gastritis can be caused by a million things , even something you ate , alcohol etc.
What i'm saying is that if someone had low acid in their stomach , they would probably have gastritis . Having no acid in your stomach can cause atrophic gastritis ... H pylori is another good example . It depletes the acid out of the stomach thus causing gastritis . A person with low acid wouldn't apt to have a perfect looking stomach.
Gastritis is caused by a number of factors including an imbalance of pepsin vs acid vs bile ( it could be too much acid , too little acid , could be too much bile etc ) Also playing a role is how much mucous you produce ( the muscous that lines the stomach ) The stomach lining also thins out due to wear and tear , aging, taking anti inflamatories , lifestyle etc.
So gastritis is caused by a combination of stuff . An imbalance / and / or how well your body can protect itself
Thanks Tricia........it makes me wonder if my sjogrens isn't playing a role in it....bc you said according how much mucous....well I'm assumming you mean normal mucus....well with this I have no moisture anywhere.......my eyes, mouth, throat you name its as dry as the desert........and I noticed that it affects the gi system......just wondering if this is what they are talking about?.....makes me wonder........thanks again.......
Thanks so much Tricia, lots of useful information there. Your advice has helped clear up some of the arbitrary information I had swirling around my head.
Heidelberg Capsule Test
Wow, I can't believe I never saw this thread...I must put in my 2 cents here immediately....
I'm repeating part of this post from another thread because there seems to be a lot of confusion about this and this directly addresses Slips and Tangles' question:
The answer to your question is: It's called a HEIDELBERG CAPSULE TEST.
Generally speaking, you have to find a complementary medicine doctor who has the equipment to do it. I found a gastroenterologist who is into a more holistic approach than the average GI who had the machine. It’s not the most pleasant procedure, but it’s not that bad. And all of us here have been through far worse procedures, actually.
You swallow a capsule (looks like a vitamin pill) which has a thread attached to it and they tape the thread to your cheek to keep the capsule tethered in your stomach (otherwise it would keep going on through your digestive system). The capsule sends radio waves to a receiving machine that shows real-time information about your stomach acid. The doctor monitors the information on a screen in front of him/her. The capsule stays in for about a half hour and they measure your stomach acid by looking at the screen . They have you swallow some water with Sodium Bicarb to change the pH and see what happens. Then, they pull it back out when they're finished (and you gag as it comes out - but it wasn't as bad as I expected).
Here is a link to the info. And the site has a way to search geographically for doctors who do the procedure:
Do not confuse this test with a Bravo Capsule or regular Ph monitoring study...those ONLY monitor the acid level in your esophagus. The Heidelberg monitors the acid level in your stomach. This tells you how much acid is being produced, whereas the Bravo and regular Ph monitoring show what's being refluxed.
And YES, many of us DO HAVE LOW STOMACH ACID. I am one of them. Reflux is not about having "too much acid". Reflux is about acid, bile, and whatever else is supposed to be in your stomach being in the wrong place (your esophagus). Even if you have too little acid, if your LES is open and lets that acid into your esophagus, you'll have reflux.
In normal people, when the stomach produces acid in the right quantity, this signals the LES to close. The problem, if you don't produce enough acid, is that there is nothing signaling your LES to keep shut because digestion is taking place. So it stays open. Hence, reflux. Some people can take HCL supplements to compensate for this. I cannot (at least for now).
Again, the tests you usually see discussed on this site measure the acid level in your esophagus - not what is produced in your stomach. They are done for entirely different purposes.
Oh, by the way...I'm not 80. I'm in my 40's. I've never had h-Pylori and I've never had any gastric surgery. And yes, my B-12 is low. And when this started, I had gastritis (I've gotten that under control).